[Development and performance evaluation of whole body emission scannography with Positologica-II].
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Biomedical subjects
Publications and source records attributed to Y Tateno.
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Nuclear magnetic resonance (NMR) imaging of the brainstem region from 12 asymptomatic individuals were reviewed in addition to these of 12 patients with various symptoms of small brainstem lesions. Abnormalities consisted of 3 cases of multiple sclerosis, 1 case of neuro-Behçet disease, 5 cases of infarction and hematoma and 3 cases of degenerative disease. NMR transverse imaging using inversion recovery sequence was able to locate many of the normal intra-axial brainstem nuclei, such as the periaqueductal gray matter, the red nucleus, the substantia nigra, the pontine nuclei, the pontine reticular nuclei, the facial nerve nucleus and so on in an about half of 12 asymptomatic individuals. The remarkable gray-white matter differentiation was obtained on NMR imaging using inversion recovery sequence and enabled the internal structures to be visualized within the brainstem. In addition, the midsagittal imaging provided an excellent demonstration of anatomical relationships of the brainstem and surrounding structures. In the diencephalic region, the mamillary body, the anterior commissure and the optic chiasma were also demonstrated on the midsagittal imaging. The lesions within the brainstem were vaguely shown on X-ray computed tomography in 6 of 12 patients but NMR imaging using inversion recovery or spin echo sequence provided more detailed data and revealed clear small lesions, such as the demyelinated plaques of multiple sclerosis and lacunar infarcts in 9 of 12 patients. Especially, in 2 of 3 multiple sclerosis patients, the plaques of the brainstem were definitely identified on NMR imaging only and the accurate localized lesion which was responsible for the facial myokymia or the Foville syndrome was identified.(ABSTRACT TRUNCATED AT 250 WORDS)
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The purpose of this study is to evaluate the clinical efficacy of liver SPECT (single photon emission computed tomography). Eleven hospitals which are in or near Tokyo are participating in this study. Planar liver images and SPECT images of 134 cases which were retrospectively confirmed for its final diagnosis were collected. At the first study, the planar images (PS) were read by 13 nuclear medicine physicians. The second, the image reading by the combination of the planar images and the SPECT images (PS + SPECT) were performed. The confidence level of diagnosis for SOL (space occupying lesion) obtained by the image reading of PS and PS + SPECT has been analyzed by using the SOL detection model. The SOL detectability of PS + SPECT was higher than that of PS only. However, these differences were not statistically significant.
The purpose of this study is to evaluate the clinical efficacy of liver SPECT (single photon emission computed tomography). The two examinations were performed in 76 cases with SOL (space occupying lesion) and 58 normal cases. The results of the image reading by the planar image only (PS) and that of the image reading by the combination of PS and SPECT (PS + SPECT) were analyzed by ROC (receiver operating characteristic) analysis. The ROC curves showed that SPECT appears to reduce the number of results which were equivocal by the image reading of PS only. The detectability of SPECT for SOL in the left lobe of liver was less than that of PS without statistical significance. However, the performance of SPECT for SOL in the right lobe of liver was significantly better than that of PS.
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Magnetic resonance imaging (MRI) was performed for 10 patients with cardiovascular thrombi using a 0.1-Tesla resistive type apparatus (ASAHI MARK-J). In all cases thrombi were clearly imaged by NMR and their shapes closely resembled those imaged by X-ray CT. Mural thrombi located within left ventricular aneurysms of two patients with old anteroseptal myocardial infarction were semilunar in form. A mural thrombus in the right ventricle of a patient with cardiovascular Behcet's disease was also clearly imaged. Mural thrombi within the enlarged left atrium of two patients with mitral valve stenosis and insufficiency were clearly demonstrated in both cross- and longitudinal sections. In three patients with thoracic aortic aneurysm, mural thrombi were recognized within the local dilatations of the aorta. In two patients with dissecting aortic aneurysm, mural thrombi were visualized within false lumen using MRI. Mean T1 values and standard deviations for the left ventricular cavity, the left ventricular wall, and the thrombi were 639 +/- 49, 349 +/- 17 and 316 +/- 84 msec, respectively. Mean T1 values of the thrombi were usually shorter than those of the left ventricular wall. Some supposedly fresh thrombi had longer T1 values, however.
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In the present study, positron computed tomography (PCT) was used to evaluate the myocardial uptake of N-13 ammonia in patients with hypertrophic cardiomyopathy (HCM). Eight subjects including two normal persons, four patients with HCM, and two with old myocardial infarction (OMI) were selected for the study. N-13 ammonia was administered intravenously as a bolus and, commencing with the tracer injection, serial 30-second PCT scans were performed. The results were summarized as follows: The first scan exhibiting cardiac blood pool images revealed a reduced left ventricular cavity in the HCM subjects. After clearance of N-13 from the cardiopulmonary vasculature, the left ventricular myocardium was clearly visualized and an increased myocardial mass with characteristic morphology was demonstrated in the HCM subjects. Detailed analysis of the time-activity curves of the blood pool and myocardium derived from these serial scan images disclosed two uptake phases in the uptake mode of N-13 ammonia. In the initial phase within three minutes, the myocardial uptake of N-13 was rapid in the normal and OMI subjects, whereas its significant delay was observed in the HCM subjects. This may reflect an abnormal initial extraction of N-13 ammonia in the HCM patients compared with the other subjects. Subsequently, in the second phase, which was characterized by a gradual increase of N-13 in the myocardium, the HCM subjects revealed higher uptake ratios than did the others. This may indicate an increased extraction of metabolites of N-13 ammonia during the second phase. These preliminary results underscore the usefulness of dynamic PCT with N-13 ammonia for the assessment of HCM.
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